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Diagnosis

Low gonadotropins on a sensitive assay are consistent with central hypogonadism and further evaluation should focus on looking for pituitary hormone deficiencies, chronic disease, undernutrition, hyperprolactinemia, or CNS abnormalities

A radiograph of the left hand and wrist should be done to assess bone age;if bone age is delayed (< 12 years) and growth velocity is normal, constitutional growth delay is the most likely diagnosis